Bortezomib
It is the first drug in the class of anti-cancer agents known as Proteasome Inhibitors. The boron atom in the drug binds with high specificity and efficacy to the site of 26S proteasome.It is recommended for the treatment of patients suffering from Multiple Myeloma who have undergone two prior therapies and are progressing on their most recent therapy. It is also indicated for treatment of Mantle Cell Lymphoma.
Administered i.v. as 3-5 second bolus in combination with oral mephalan and oral prednisolone for nine six-week treatment cycles. It is administered twice weekly in cycles 1-4 and once weekly in cycles 5-9. At least 72 hours should elapse between two consecutive doses of Bortezomib.
Hypersensitivity to Bortezomib, boron or mannitol.
Pregnancy Category D Medication. Women of child bearing age should avoid becoming pregnant when taking this medication.
Peripheral Neuropathy, hypertension, cardiac disease, pulmonary disease, G.I disturbances, thrombocytopenia/neutropenia, Tumor Lysis Syndrome, hepatic disturbances.
CyP3A4 inhibitor Anti-fungal agents like Ketoconozole, Ritonavir are reported to enhance the effect of Bortezomib and are to be avoided. Cytochrome P450 inhibitors or inducer agents are also reported to enhance or reduce the efficacy of Bortezomib. Green Tea extract epigallocatechin gallate has been reported to reduce the effectiveness of Bortezomib.
